NPI 1366701575 · live from the CMS NPI Registry
Age Management & Internal Medicine Consultants INC.
Internal Medicine in Kent, OH. National Provider Identifier 1366701575, active.
NPI record
| NPI | 1366701575 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Internal Medicine 207R00000X |
| Practice location | 1949 State Route 59, Suite 102, Kent, OH 44240 |
| Practice phone | 330-673-0505 |
| Mailing address | 1559 Elizabeth Ct, Kent, OH 44240 |
| Enumerated | May 8, 2012 |
| Last updated | May 8, 2012 |
| Authorized official | Victor Kopyev, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Internal Medicine primary | 207R00000X | 35-074815 (OH) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.